Individual provider Active NPI

Kevin L Jones, MD

  • Pediatrics Physician
  • Mooresville, IN
National Provider Identifier
1558398024
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
01046699A Issued in IN
Practice address
820 N Samuel Moore Pkwy
Ste a
Mooresville, IN 46158-1467
Phone
(317) 483-5080
Fax
(317) 483-5085
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 01046699A IN Primary

Addresses

Primary practice location

820 N Samuel Moore Pkwy
Ste a
Mooresville, IN 46158-1467

Mailing address

250 N Shadeland Ave
Ste 130 Provider Enrollment
Indianapolis, IN 46219-4959

Other identifiers 1

IdentifierTypeStateIssuer
200139740MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kjones9@direct.iuhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120123000079 IN Practitioner - Pediatric Medicine 9830366475 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01046699AINMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Care Associates, Inc CurrentSince Jan 1, 2012 Accepting new patients
University Family Physicians, Inc. CurrentSince Apr 17, 2015 Accepting new patients
University Family Physicians, Inc. CurrentSince Apr 17, 2015 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Jul 1, 2025 Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients
Major Hospital Past Accepting new patients

Locations

5208 Reliable Pkwy
Chicago, IL 60686

7216 Solutions Ctr
Chicago, IL 60677

1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000

1520 N Senate Ave
Indianapolis, IN 46202
Phone (317) 962-0857

5550 S East St
Ste I
Indianapolis, IN 46227
Phone (317) 780-4080

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219
Phone (317) 962-4836

820 N Samuel Moore Pkwy
Ste C
Mooresville, IN 46158
Phone (317) 483-5080

820 N Samuel Moore Pkwy
Ste A
Mooresville, IN 46158
Phone (317) 483-5000

820 N Samuel Moore Pkwy
#C
Mooresville, IN 46158

820 N Samuel Moore Pkwy
Mooresville, IN 46158
Phone (317) 483-5000

Interoperability endpoints

  • Direct secure messaging: kjones9@direct.iuhealth.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1558398024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "address_2": "STE 130 PROVIDER ENROLLMENT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 N SAMUEL MOORE PKWY",
            "address_2": "STE A",
            "city": "MOORESVILLE",
            "state": "IN",
            "postal_code": "461581467",
            "telephone_number": "317-483-5080",
            "fax_number": "317-483-5085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "KEVIN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01046699A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200139740",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kjones9@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "820 N Samuel Moore Pkwy",
            "address_2": "Ste A",
            "city": "Mooresville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461581467",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mooresville, IN

Sources for this page

Verify at the official NPI Registry.